Comparative Outcomes of Transoral Versus Transcervical Approach for Extrapharyngeal Foreign Body Removal

Area of Science:

• Otolaryngology
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Foreign bodies in the retropharyngeal and parapharyngeal spaces present a surgical challenge.
• Traditional transcervical approaches can involve significant morbidity.
• Advancements in surgical techniques aim to improve patient outcomes.

Purpose of the Study:

• To compare the clinical outcomes of transoral microlaryngoscopy versus transcervical approaches for extra-pharyngeal foreign body removal.
• To evaluate the efficacy and safety of each surgical method.
• To determine the optimal surgical strategy based on preoperative imaging.

Main Methods:

• Retrospective analysis of clinical data from 21 patients with extra-pharyngeal foreign bodies.
• Procedures included transoral microlaryngoscopy or transcervical incision based on CT localization.
• Statistical analysis using Fisher's exact tests, independent T-tests, and Mann-Whitney U test.

Main Results:

• Transoral microlaryngoscopy group had shorter hospital stays (mean 3.8 days vs. 14.9 days) and lower costs.
• Operation times were significantly shorter for transoral microlaryngoscopy (66.8 min vs. 170.8 min).
• The transoral group had no tracheostomies or complications, unlike the cervical incision group (37.5% tracheostomies, 37.5% complications).

Conclusions:

• Transoral microlaryngoscopy is a superior approach for accessible extra-pharyngeal foreign bodies.
• Preoperative CT localization is crucial for selecting the appropriate surgical strategy.
• Minimally invasive techniques offer significant advantages in patient recovery and safety.